Grants

"Care plans are essential for families with chronically ill children. Providing a plan of care that is easy to find and accessible will enable providers to make each encounter more efficient, effective, and patient-centered." Stacey C. Cook, PhD, MD, Children’s Hospital of Pittsburgh of UPMC

Development of a Comprehensive Care Plan for Children with Special Health Care Needs (CSHCN)

Grant Application

Stacey C. Cook, PhD, MD, Children’s Hospital of Pittsburgh of UPMC

Proposed Innovation

Advances in technology and clinical care over the last 30 years have allowed children with medically complex health care needs to live longer — remaining outside the hospital and thriving as outpatients. The newly opened Complex Care Center at Children’s Hospital provides these patients with open access for well child are and urgent care visits 5 days a week with 24/7 telephone coverage by providers who are familiar with their cases.

This Beckwith Grant will be used to develop a comprehensive, individualized care plan for every patient enrolled in the clinic to ensure streamlined communication between providers, families, and caregivers.

Improvements in Action

An advisory panel of parents, providers, school nurses, and home health staff will be established to provide input and feedback regarding the design, format, and content of the care plan to be used in the multidisciplinary clinic. Once the design is created in a paper format, the care plan will be integrated into the electronic health record (EHR) for rapid identification of patients and easy access to a summary of their needs and treatment goals.

Intended Outcomes

Establishing an individualized care plan for patients with unique and challenging medical conditions will help to ensure they receive much needed care coordination. This collaborative approach to care plan design is expected to lead to improved patient outcomes and greater overall patient satisfaction with the health care experience.